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EP2184065B1 - Ivabradine and its use in a method of diagnosis using coronary angiography with multi-slice computed tomography - Google Patents

Ivabradine and its use in a method of diagnosis using coronary angiography with multi-slice computed tomography Download PDF

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Publication number
EP2184065B1
EP2184065B1 EP09290841A EP09290841A EP2184065B1 EP 2184065 B1 EP2184065 B1 EP 2184065B1 EP 09290841 A EP09290841 A EP 09290841A EP 09290841 A EP09290841 A EP 09290841A EP 2184065 B1 EP2184065 B1 EP 2184065B1
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Prior art keywords
ivabradine
coronary angiography
computed tomography
heart rate
administration
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German (de)
French (fr)
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EP2184065A1 (en
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Guy Lerebours-Pigeonniere
Ariane Dubost-Brama
Carmen Fleurinck
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Laboratoires Servier SAS
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Laboratoires Servier SAS
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Priority to PL09290841T priority Critical patent/PL2184065T3/en
Priority to SI200930057T priority patent/SI2184065T1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K49/00—Preparations for testing in vivo
    • A61K49/04—X-ray contrast preparations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K49/00—Preparations for testing in vivo
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K49/00—Preparations for testing in vivo
    • A61K49/0002—General or multifunctional contrast agents, e.g. chelated agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00—Drugs for disorders of the cardiovascular system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00—Drugs for disorders of the cardiovascular system
    • A61P9/06—Antiarrhythmics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00—Drugs for disorders of the cardiovascular system
    • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis

Definitions

  • the present invention relates to the use of ivabradine or 3- ⁇ 3 - [ ⁇ [(7S) -3,4-dimethoxybicyclo [4.2.0] octa-1,3,5-trien-7-yl] -methyl ⁇ - (methyl) amino] propyl ⁇ -7,8-dimethoxy-1,3,4,5-tetrahydro-2 H -3-benzazepin-2-one of formula (I): as well as its addition salts with a pharmaceutically acceptable acid and the hydrates of said addition salts, in a method of diagnosis using the method of coronary angiography by means of a multi-computed tomodensitometry.
  • Ivabradine as well as its addition salts with a pharmaceutically acceptable acid, and more particularly its hydrochloride, and the hydrates of said addition salts, possess very interesting pharmacological and therapeutic properties. They directly and selectively reduce cardiac pacemaker activity, which gives them negative chronotropic properties (reduction of heart rate), without affecting blood pressure, which allows them to be considered in treatment, prevention and treatment. Improved prognosis of various cardiovascular diseases related to myocardial ischemia such as angina pectoris, myocardial infarction and in chronic heart failure
  • ivabradine and its addition salts more particularly its hydrochloride, possessed interesting properties allowing their use in a method of diagnosis using the method of coronary angiography by means of a multi-computed tomodensitometry.
  • Computed Tomography Coronary Angiography also called MDCT-CA (MultiDetector Computed Tomography Coronary Angiography)
  • MSCT-CA Computed Tomography Coronary Angiography
  • MDCT-CA MultiDetector Computed Tomography Coronary Angiography
  • This method avoids the use of the conventional technique of cardiac catheterization angiography, which, by its invasiveness, involves risks.
  • an iodinated contrast medium is injected into the patient to opacify the coronary lumen. Images are then acquired by X-ray radiation using a multi-strip scanner (ie multi-detector).
  • Coronary arteries are small, tortuous, fast-moving vessels that are difficult to image. Therefore, a high spatial and temporal resolution is required to analyze them correctly. It is even better than the number of bars is high.
  • the multi-strip scanner usually has 4 to 64 detectors.
  • the latest scanners have 64 detectors, and sometimes a dual X-ray source, which increases the temporal resolution capability of the technique.
  • PANNU HK AND AL (AMERICAN JOURNAL OF ROENTGENOLOGY, vol 186, No. 6 SUPPL A, pages S341-S345 ) and SHAPIRO ET AL (EUROPEAN JOURNAL OF RADIOLOGY, 66, pages 37-41 ) describe a clinical trial protocol for the administration of metoprolol, a beta-blocker, in patients undergoing coronary angiography by multi-scan computed tomography to improve the quality of images obtained by lowering the heart rate.
  • ivabradine is able to lower the heart rate early. This property makes it possible to envisage the use of ivabradine in patients having a high heart rate subjected to coronary angiography by means of a multi-computed tomodensitometry to improve the quality of the images obtained. In addition, a reduction in irradiation could be considered by reducing the heart rate.
  • the present invention relates to the use of ivabradine, its addition salts with a pharmaceutically acceptable acid and hydrates of said salts, for obtaining compositions used in a method of diagnosis using the method of coronary angiography by computed tomodensitometry.
  • compositions are in a form suitable for oral or intravenous administration, preferably intravenously.
  • the useful dosage varies according to the resting heart rate of the person to be examined and ranges from 2 to 20 mg per administration.
  • Intravenous administration is by bolus or infusion.
  • bolus is meant a rapid administration, a duration preferably less than 30 seconds.
  • compositions suitable for intravenous administration may be in the form of injectable solution or lyophilizate to be dissolved in a solvent prior to administration.
  • the injectable solution is preferably a saline solution.
  • the concentration of ivabradine base in the injectable solution is preferably between 1 and 5 mg / ml.
  • the percentage of active ingredient of formula (I) in the solution for injection is preferably between 0.1% and 0.5% by weight.
  • the percentage of active ingredient of formula (I) in the lyophilizate is preferably between 10% and 50% by weight.
  • compositions suitable for oral administration contain, in addition to ivabradine, one of its addition salts with a pharmaceutically acceptable acid or one of the hydrates of one of said addition salts, one or more excipients or vehicles such as of the diluents, lubricants, binders, disintegrants, absorbents, colorants, sweeteners.
  • the percentage of active ingredient of formula (I) in the composition for administration orally is preferably between 3% and 50% by weight.
  • the resting heart rate (in the extended position) is measured at T0.
  • the resting heart rate (in the extended position) is measured again at T0 + 30 min.
  • the heart rate is 16% lower than the heart rate of the control group.
  • Patients selected for this study have a resting heart rate equal to or greater than 70 bpm.
  • the patient's resting heart rate is measured at T0.
  • Patients with a heart rate between 70 bpm and 79 bpm receive an iv bolus of ivabradine hydrochloride solution dosed at 10 mg ivabradine base (treated group) or placebo (control group).
  • Patients with a heart rate equal to or greater than 80 bpm receive an iv bolus of ivabradine hydrochloride solution dosed at 15 mg ivabradine base (treated group) or placebo (control group).
  • the resting heart rate is measured continuously after the bolus injection. As soon as the heart rate is below 65 bpm, the patient is subjected to coronary angiography. A contrast product is injected into the patient. Images are then acquired by X-ray radiation using a multi-strip scanner with at least 64 detectors.
  • the components are mixed and the resulting solution distributed in 1000 ampoules with a capacity of 10 ml each.
  • the components are mixed, the resulting solution distributed in 1000 ampoules of a capacity of 10 ml each.
  • Example 2 The components of Example 2 are mixed, the resulting solution is distributed in 1000 ampoules of 10 ml each, which are then lyophilized.
  • Preparation formula for 1000 tablets dosed with 5 mg of ivabradine base Ivabradine hydrochloride 5.39 g Corn starch 20 g Anhydrous colloidal silica 0.2 g mannitol 63.91 g Povidone (PVP) 10 g Magnesium stearate 0.5 g

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  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Epidemiology (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Chemical & Material Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Urology & Nephrology (AREA)
  • Medicines Containing Antibodies Or Antigens For Use As Internal Diagnostic Agents (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Organic Low-Molecular-Weight Compounds And Preparation Thereof (AREA)
  • Medicinal Preparation (AREA)
  • Investigating Or Analysing Biological Materials (AREA)

Description

La présente invention concerne l'utilisation de l'ivabradine ou 3-{3-[{[(7S)-3,4-diméthoxybicyclo[4.2.0]octa-1,3,5-trién-7-yl]-méthyl}-(méthyl)-amino]-propyl}-7,8-diméthoxy-1,3,4,5-tétrahydro-2H-3-benzazépin-2-one de formule (I):

Figure imgb0001
ainsi que ses sels d'addition à un acide pharmaceutiquement acceptable et les hydrates desdits sels d'addition, dans une méthode de diagnostic utilisant la méthode d'angiographie coronaire par tomodensitométrie multicoupe.The present invention relates to the use of ivabradine or 3- {3 - [{[(7S) -3,4-dimethoxybicyclo [4.2.0] octa-1,3,5-trien-7-yl] -methyl } - (methyl) amino] propyl} -7,8-dimethoxy-1,3,4,5-tetrahydro-2 H -3-benzazepin-2-one of formula (I):
Figure imgb0001
 as well as its addition salts with a pharmaceutically acceptable acid and the hydrates of said addition salts, in a method of diagnosis using the method of coronary angiography by means of a multi-computed tomodensitometry.

L'ivabradine, ainsi que ses sels d'addition à un acide pharmaceutiquement acceptable, et plus particulièrement son chlorhydrate, et les hydrates desdits sels d'addition, possèdent des propriétés pharmacologiques et thérapeutiques très intéressantes.
Ils réduisent de façon directe et sélective l'activité pacemaker cardiaque, ce qui leur confère des propriétés chronotropes négatives (réduction de la fréquence cardiaque), sans affecter la pression artérielle, ce qui permet de les envisager dans le traitement, la prévention et l'amélioration du pronostic de différentes maladies cardio-vasculaires liées à l'ischémie myocardique telles que l'angine de poitrine, l'infarctus du myocarde et dans l'insuffisance cardiaque chroniqueIvabradine, as well as its addition salts with a pharmaceutically acceptable acid, and more particularly its hydrochloride, and the hydrates of said addition salts, possess very interesting pharmacological and therapeutic properties.
They directly and selectively reduce cardiac pacemaker activity, which gives them negative chronotropic properties (reduction of heart rate), without affecting blood pressure, which allows them to be considered in treatment, prevention and treatment. Improved prognosis of various cardiovascular diseases related to myocardial ischemia such as angina pectoris, myocardial infarction and in chronic heart failure

La préparation et l'utilisation en thérapeutique de l'ivabradine et de ses sels d'addition à un acide pharmaceutiquement acceptable, et plus particulièrement de son chlorhydrate, ont été décrits dans le brevet européen EP 0 534 859 .The preparation and therapeutic use of ivabradine and its addition salts with a pharmaceutically acceptable acid, and more particularly its hydrochloride, have been described in the European patent EP 0 534 859 .

La demanderesse a présentement trouvé que l'ivabradine et ses sels d'addition, plus particulièrement son chlorhydrate, possédaient des propriétés intéressantes permettant leur utilisation dans une méthode de diagnostic utilisant la méthode d'angiographie coronaire par tomodensitométrie multicoupe.The Applicant has currently found that ivabradine and its addition salts, more particularly its hydrochloride, possessed interesting properties allowing their use in a method of diagnosis using the method of coronary angiography by means of a multi-computed tomodensitometry.

L'angiographie coronaire par tomodensitométrie multicoupe, ou MSCT-CA (MultiSlice Computed Tomography Coronary Angiography), encore appelée MDCT-CA (MultiDetector Computed Tomography Coronary Angiography), est une technique rapide et non invasive permettant d'examiner les artères coronaires et de détecter par imagerie une maladie coronarienne, notamment le rétrécissement (sténose) ou l'obstruction des coronaires, ainsi que d'évaluer l'anatomie et la perméabilité des vaisseaux, et de caractériser les plaques athéromateuses au niveau tissulaire. Cette méthode évite le recours à la technique classique d'angiographie par cathétérisme cardiaque, qui, de par son caractère invasif, comporte des risques.Computed Tomography Coronary Angiography (MSCT-CA), also called MDCT-CA (MultiDetector Computed Tomography Coronary Angiography), is a fast, noninvasive technique for examining coronary arteries and detecting imaging coronary heart disease, including narrowing (stenosis) or coronary obstruction, as well as assessing vessel anatomy and permeability, and characterizing atheromatous plaques at the tissue level. This method avoids the use of the conventional technique of cardiac catheterization angiography, which, by its invasiveness, involves risks.

Dans la méthode d'angiographie coronaire par tomodensitométrie multicoupe, un produit de contraste iodé est injecté au patient pour opacifier la lumière des coronaires. L'acquisition des images se fait ensuite par radiation aux rayons X à l'aide d'un scanner multi-barrettes (c'est-à-dire multi-détecteurs).In the multicomponent computed tomography angiography method, an iodinated contrast medium is injected into the patient to opacify the coronary lumen. Images are then acquired by X-ray radiation using a multi-strip scanner (ie multi-detector).

Les artères coronaires sont des vaisseaux de petit calibre, tortueux et en mouvement rapide, donc difficiles à imager. Par conséquent, une résolution élevée à la fois spatiale et temporelle est requise pour les analyser correctement. Elle est d'autant meilleure que le nombre de barrettes est élevé.Coronary arteries are small, tortuous, fast-moving vessels that are difficult to image. Therefore, a high spatial and temporal resolution is required to analyze them correctly. It is even better than the number of bars is high.

Le scanner multi-barrettes a en général de 4 à 64 détecteurs. Les scanners les plus récents sont munis de 64 détecteurs, et parfois d'une double source de rayons X, qui augmente la capacité de résolution temporelle de la technique.The multi-strip scanner usually has 4 to 64 detectors. The latest scanners have 64 detectors, and sometimes a dual X-ray source, which increases the temporal resolution capability of the technique.

D'autre part, en raison des artéfacts de mouvements, la qualité des images est affectée par une fréquence cardiaque élevée.On the other hand, because of motion artifacts, image quality is affected by high heart rate.

PANNU H K ET AL (AMERICAN JOURNAL OF ROENTGENOLOGY, vol. 186, no. 6 SUPPL. A, pages S341-S345 ) et SHAPIRO ET AL (EUROPEAN JOURNAL OF RADIOLOGY, vol. 66 , pages 37- 41 ) décrivent un protocole d'étude clinique pour l'administration du métoprolol, un bêta-bloquant, chez les patients soumis à une angiographie coronaire par tomodensitométrie multicoupe pour améliorer la qualité des images obtenues en baissant la fréquence cardiaque. PANNU HK AND AL (AMERICAN JOURNAL OF ROENTGENOLOGY, vol 186, No. 6 SUPPL A, pages S341-S345 ) and SHAPIRO ET AL (EUROPEAN JOURNAL OF RADIOLOGY, 66, pages 37-41 ) describe a clinical trial protocol for the administration of metoprolol, a beta-blocker, in patients undergoing coronary angiography by multi-scan computed tomography to improve the quality of images obtained by lowering the heart rate.

La demanderesse a présentement trouvé que l'ivabradine était capable de baisser la fréquence cardiaque de façon précoce. Cette propriété permet d'envisager l'utilisation de l'ivabradine chez les patients ayant une fréquence cardiaque élevée soumis à une angiographie coronaire par tomodensitométrie multicoupe pour améliorer la qualité des images obtenues. De plus, une réduction de l'irradiation pourrait être envisagée par la réduction de la fréquence cardiaque.The Applicant has currently found that ivabradine is able to lower the heart rate early. This property makes it possible to envisage the use of ivabradine in patients having a high heart rate subjected to coronary angiography by means of a multi-computed tomodensitometry to improve the quality of the images obtained. In addition, a reduction in irradiation could be considered by reducing the heart rate.

Ainsi, la présente invention concerne l'utilisation de l'ivabradine, de ses sels d'addition à un acide pharmaceutiquement acceptable et des hydrates desdits sels, pour l'obtention de compositions utilisées dans une méthode de diagnostic utilisant la méthode d'angiographie coronaire par tomodensitométrie multicoupe.Thus, the present invention relates to the use of ivabradine, its addition salts with a pharmaceutically acceptable acid and hydrates of said salts, for obtaining compositions used in a method of diagnosis using the method of coronary angiography by computed tomodensitometry.

Les compositions sont sous une forme convenant à une administration par voie orale ou intraveineuse, préférentiellement par voie intraveineuse.The compositions are in a form suitable for oral or intravenous administration, preferably intravenously.

La posologie utile varie selon la fréquence cardiaque au repos de la personne à examiner et s'échelonne de 2 à 20 mg par administration.The useful dosage varies according to the resting heart rate of the person to be examined and ranges from 2 to 20 mg per administration.

L'administration par voie intraveineuse est effectuée en un bolus ou par perfusion.Intravenous administration is by bolus or infusion.

Par bolus, on entend une administration rapide, d'une durée préférentiellement inférieure à 30 secondes.By bolus is meant a rapid administration, a duration preferably less than 30 seconds.

Les compositions convenant pour une administration par voie intraveineuse peuvent être sous forme de solution injectable ou de lyophilisat à dissoudre dans un solvant avant administration.
La solution injectable est préférentiellement une solution saline.
La concentration d'ivabradine base dans la solution injectable est préférentiellement comprise entre 1 et 5 mg/ml.
Le pourcentage de principe actif de formule (I) dans la solution injectable est préférentiellement compris entre 0.1% et 0.5% en poids.Compositions suitable for intravenous administration may be in the form of injectable solution or lyophilizate to be dissolved in a solvent prior to administration.
The injectable solution is preferably a saline solution.
The concentration of ivabradine base in the injectable solution is preferably between 1 and 5 mg / ml.
The percentage of active ingredient of formula (I) in the solution for injection is preferably between 0.1% and 0.5% by weight.

Le pourcentage de principe actif de formule (I) dans le lyophilisat est préférentiellement compris entre 10% et 50% en poids.The percentage of active ingredient of formula (I) in the lyophilizate is preferably between 10% and 50% by weight.

Les compositions convenant pour une administration par voie orale contiennent, outre l'ivabradine, un de ses sels d'addition à un acide pharmaceutiquement acceptable ou un des hydrates de l'un desdits sels d'addition, un ou plusieurs excipients ou véhicules tels que des diluants, des lubrifiants, des liants, des agents de désintégration, des absorbants, des colorants, des édulcorants.The compositions suitable for oral administration contain, in addition to ivabradine, one of its addition salts with a pharmaceutically acceptable acid or one of the hydrates of one of said addition salts, one or more excipients or vehicles such as of the diluents, lubricants, binders, disintegrants, absorbents, colorants, sweeteners.

A titre d'exemple et de manière non limitative, on peut citer :

  • ◆ pour les diluants : le lactose, le dextrose, le sucrose, le mannitol, le sorbitol, la cellulose, la glycérine,
  • ◆ pour les lubrifiants : la silice, le talc, l'acide stéarique et ses sels de magnésium et de calcium, le polyéthylène glycol,
  • ◆ pour les liants : le silicate d'aluminium et de magnésium, l'amidon, la gélatine, la tragacanthe, la méthylcellulose, la carboxyméthylcellulose de sodium et la polyvinylpyrrolidone (PVP),
  • ◆ pour les désintégrants : l'agar, l'acide alginique et son sel de sodium, les mélanges effervescents.
By way of example and in a nonlimiting manner, mention may be made of:
  • ◆ for diluents : lactose, dextrose, sucrose, mannitol, sorbitol, cellulose, glycerine,
  • ◆ for lubricants : silica, talc, stearic acid and its magnesium and calcium salts, polyethylene glycol,
  • ◆ for binders : aluminum magnesium silicate, starch, gelatin, tragacanth, methylcellulose, sodium carboxymethylcellulose and polyvinylpyrrolidone (PVP),
  • ◆ for disintegrants : agar, alginic acid and its sodium salt, effervescent mixtures.

Le pourcentage de principe actif de formule (I) dans la composition pour administration par voie orale est préférentiellement compris entre 3% et 50% en poids.The percentage of active ingredient of formula (I) in the composition for administration orally is preferably between 3% and 50% by weight.

EXEMPLE 1 : Etude clinique. Effet d'une administration i.v. du chlorhydrate d'ivabradine sur la fréquence cardiaque chez le volontaire sain. EXAMPLE 1 Clinical Study Effect of iv administration of ivabradine hydrochloride on heart rate in healthy volunteers.

La fréquence cardiaque au repos (en position allongée) est mesurée à T0. Les sujets reçoivent ensuite un bolus i.v. d'une solution de chlorhydrate d'ivabradine dosée à 16 mg d'ivabradine base (groupe traité, n=8) ou de placebo (groupe témoin, n=2).The resting heart rate (in the extended position) is measured at T0. Subjects are then given an i.v. bolus of ivabradine hydrochloride solution dosed with either ivabradine base (treated group, n = 8) or placebo (control group, n = 2).

La fréquence cardiaque au repos (en position allongée) est mesurée à nouveau à T0 + 30 min.The resting heart rate (in the extended position) is measured again at T0 + 30 min.

Résultats :Results:

Chez les sujets traités par l'ivabradine, la fréquence cardiaque est inférieure de 16% par rapport à la fréquence cardiaque du groupe témoin.In subjects treated with ivabradine, the heart rate is 16% lower than the heart rate of the control group.

EXEMPLE 2 : Etude clinique. Effet d'une administration i.v. du chlorhydrate d'ivabradine sur la fréquence cardiaque chez le patient soumis à une angiographie coronaire par tomodensitométrie multicoupe. EXAMPLE 2 : Clinical Study Effect of ivabradine hydrochloride iv administration on heart rate in patients undergoing coronary angiography using multi-computed tomodensitometry.

Les patients sélectionnés pour cette étude ont une fréquence cardiaque au repos égal ou supérieure à 70 bpm.
La fréquence cardiaque au repos du patient est mesurée à T0.
Les patients ayant une fréquence cardiaque comprise entre 70 bpm et 79 bpm reçoivent un bolus iv d'une solution de chlorhydrate d'ivabradine dosée à 10 mg d'ivabradine base (groupe traité) ou de placebo (groupe témoin).
Les patients ayant une fréquence cardiaque égale ou supérieure à 80 bpm reçoivent un bolus iv d'une solution de chlorhydrate d'ivabradine dosée à 15 mg d'ivabradine base (groupe traité) ou de placebo (groupe témoin).
La fréquence cardiaque au repos est mesurée en continu après l'injection du bolus.
Dès que la fréquence cardiaque est inférieure à 65 bpm, le patient est soumis à l'angiographie coronaire.
Un produit de contraste est injecté au patient. L'acquisition des images se fait ensuite par radiation aux rayons X à l'aide d'un scanner multi-barrettes possédant au moins 64 détecteurs.Patients selected for this study have a resting heart rate equal to or greater than 70 bpm.
The patient's resting heart rate is measured at T0.
Patients with a heart rate between 70 bpm and 79 bpm receive an iv bolus of ivabradine hydrochloride solution dosed at 10 mg ivabradine base (treated group) or placebo (control group).
Patients with a heart rate equal to or greater than 80 bpm receive an iv bolus of ivabradine hydrochloride solution dosed at 15 mg ivabradine base (treated group) or placebo (control group).
The resting heart rate is measured continuously after the bolus injection.
As soon as the heart rate is below 65 bpm, the patient is subjected to coronary angiography.
A contrast product is injected into the patient. Images are then acquired by X-ray radiation using a multi-strip scanner with at least 64 detectors.

EXEMPLE 3 : Solution injectable dosée à 10 mg/5 ml : EXAMPLE 3 Injectable solution dosed at 10 mg / 5 ml:

Formule de préparation pour 1000 ampoules dosées à 10 mg d'ivabradine base: Chlorhydrate d'ivabradine 10.78 g Chlorure de sodium 45 g Eau injectable 51 Preparation formula for 1000 ampoules dosed with 10 mg of ivabradine base: Ivabradine hydrochloride 10.78 g Sodium chloride 45 g Injectable water 51

Les composants sont mélangés et la solution résultante répartie en 1000 ampoules d'une contenance de 10 ml chacune.The components are mixed and the resulting solution distributed in 1000 ampoules with a capacity of 10 ml each.

EXEMPLE 4 : Solution injectable dosée à 15 mg/7.5 ml : EXAMPLE 4 Injectable solution dosed at 15 mg / 7.5 ml:

Formule de préparation pour 1000 ampoules dosées à 15 mg d'ivabradine base: Chlorhydrate d'ivabradine 16.17 g Chlorure de sodium 67.5 g Eau injectable 7.51 Preparation formula for 1000 ampoules dosed with 15 mg of ivabradine base: Ivabradine hydrochloride 16.17 g Sodium chloride 67.5 g Injectable water 7.51

Les composants sont mélangés, la solution résultante répartie en 1000 ampoules d'une contenance de 10 ml chacune.The components are mixed, the resulting solution distributed in 1000 ampoules of a capacity of 10 ml each.

EXEMPLE 5 : Lyophilisat pour administration par voie intraveineuse EXAMPLE 5 Lyophilisate for intravenous administration

Les composants de l'Exemple 2 sont mélangés, la solution résultante est répartie en 1000 ampoules d'une contenance de 10 ml chacune, qui sont ensuite lyophilisées.The components of Example 2 are mixed, the resulting solution is distributed in 1000 ampoules of 10 ml each, which are then lyophilized.

EXEMPLE 6 : Composition pour administration par voie orale EXAMPLE 6 Composition for oral administration

Formule de préparation pour 1000 comprimés dosés à 5 mg d'ivabradine base:Preparation formula for 1000 tablets dosed with 5 mg of ivabradine base: Chlorhydrate d'ivabradineIvabradine hydrochloride 5,39 g5.39 g Amidon de maïsCorn starch 20 g20 g Silice colloïdale anhydreAnhydrous colloidal silica 0,2 g0.2 g Mannitolmannitol 63,91 g63.91 g Povidone (PVP)Povidone (PVP) 10 g10 g Stéarate de magnésiumMagnesium stearate 0,5 g0.5 g

Claims (5)

  1. Ivabradine, or 3-{3-[{[(7S)-3,4-dimethoxybicyclo[4.2.0]octa-1,3,5-trien-7-yl]methyl}-(methyl)amino]propyl}-7,8-dimethoxy-1,3,4,5-tetrahydro-2H-3-benzazepin-2-one, its addition salts with a pharmaceutically acceptable acid or hydrates of said salts, for use in a diagnostic method using the method of coronary angiography by multislice computed tomography.
  2. Composition comprising ivabradine, or 3-{3-[{[(7S)-3,4-dimethoxybicyclo[4.2.0]octa-1,3,5-trien-7-yl]methyl}(methyl)amino]propyl}-7,8-dimethoxy-1,3,4,5-tetrahydro-2H-3-benzazepin-2-one, its addition salts with a pharmaceutically acceptable acid or hydrates of said salts, in combination with one or more pharmaceutically acceptable excipients, for use in a diagnostic method using the method of coronary angiography by multislice computed tomography.
  3. Composition according to claim 2 for use according to claim 2, characterised in that it is suitable for administration by the intravenous route.
  4. Composition according to claim 3 for use according to claim 2, in the form of an injectable solution.
  5. Composition according to claim 2 for use according to claim 2, characterised in that it is suitable for administration by the oral route.
EP09290841A 2008-11-07 2009-11-06 Ivabradine and its use in a method of diagnosis using coronary angiography with multi-slice computed tomography Active EP2184065B1 (en)

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PL09290841T PL2184065T3 (en) 2008-11-07 2009-11-06 Ivabradine and its use in a method of diagnosis using coronary angiography with multi-slice computed tomography
SI200930057T SI2184065T1 (en) 2008-11-07 2009-11-06 Ivabradine and its use in a method of diagnosis using coronary angiography with multi-slice computed tomography
CY20111100927T CY1112037T1 (en) 2008-11-07 2011-09-27 IBAVRADINI AND ITS USE IN A DIAGNOSTIC METHOD THAT USES THE METHOD OF CAMEROON CERTAIN PATHOLOGY

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FR0806225A FR2938194B1 (en) 2008-11-07 2008-11-07 USE OF IVABRADINE AS A DIAGNOSTIC AGENT IN CORONARY ANGIOGRAPHY THROUGH MULTICOUTE TOMODENSITOMETRY

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US20130084335A1 (en) * 2010-06-14 2013-04-04 Ratiopharm Gmbh Ivabradine-containing pharmaceutical composition
CN106580873A (en) * 2016-11-08 2017-04-26 北京万全德众医药生物技术有限公司 Ivabradine or pharmaceutical salt oral solution thereof, and preparation method thereof

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FR2681862B1 (en) 1991-09-27 1993-11-12 Adir Cie NOVELS (BENZOCYCLOALKYL) ALKYLAMINES, THEIR PREPARATION PROCESS, AND THE PHARMACEUTICAL COMPOSITIONS CONTAINING THEM.
ATE533509T1 (en) 2003-08-08 2011-12-15 Ono Pharmaceutical Co HEART-SLOWING DRUG WITH SHORT-TERM BETA-BLOCKERS AS ACTIVE INGREDIENTS
FR2882553B1 (en) * 2005-02-28 2007-05-04 Servier Lab CRYSTALLINE BETA FORM OF IVABRADINE HYDROCHLORIDE, PROCESS FOR PREPARING THE SAME, AND PHARMACEUTICAL COMPOSITIONS CONTAINING THE SAME
FR2894826B1 (en) * 2005-12-21 2010-10-22 Servier Lab NOVEL ASSOCIATION OF SINUSAL IF CURRENT INHIBITOR AND CALCIUM INHIBITOR AND THE PHARMACEUTICAL COMPOSITIONS CONTAINING SAME
FR2911279B1 (en) * 2007-01-11 2009-03-06 Servier Lab USE OF IVABRADINE FOR THE PRODUCTION OF MEDICAMENTS FOR THE TREATMENT OF ENDOTHELIAL DYSFUNCTION

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DE GRAAF ET AL: "Evaluation of Contraindications and Efficacy of Oral Beta Blockade Before Computed Tomographic Coronary Angiography", THE AMERICAN JOURNAL OF CARDIOLOGY, vol. 105, no. 6, - 15 March 2010 (2010-03-15), pages 767 - 772 *
GUARICCI ET AL: "Incremental value and safety of oral ivabradine for heart rate reduction in computed tomography coronary angiography", INTERNATIONAL JOURNAL OF CARDIOLOGY, - 23 November 2010 (2010-11-23) *
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FR2938194B1 (en) 2012-08-31
JP2016040304A (en) 2016-03-24
SA109300653B1 (en) 2013-05-18
HRP20110684T1 (en) 2011-10-31
CO6230160A1 (en) 2010-12-20
MY145991A (en) 2012-06-08
CA2685303C (en) 2012-04-17
IL201815A0 (en) 2010-06-30
AP2635A (en) 2013-04-05
CA2685303A1 (en) 2010-05-07
ME00953B (en) 2012-06-20
AP2009005035A0 (en) 2009-12-31
SV2009003401A (en) 2010-02-17
US20160361444A1 (en) 2016-12-15
CL2009002032A1 (en) 2010-09-10
TWI426923B (en) 2014-02-21
UA101612C2 (en) 2013-04-25
NI200900195A (en) 2011-08-03
KR101168484B1 (en) 2012-07-26
FR2938194A1 (en) 2010-05-14
NZ580984A (en) 2010-12-24
PA8847801A1 (en) 2010-06-28
PE20100744A1 (en) 2010-10-30
EA200901369A1 (en) 2011-06-30
ES2370145T3 (en) 2011-12-13
ATE516806T1 (en) 2011-08-15
AR074294A1 (en) 2011-01-05
TW201021834A (en) 2010-06-16
JP6029935B2 (en) 2016-11-24
BRPI0904376A2 (en) 2011-09-06
CN101732734A (en) 2010-06-16
AU2009235984A1 (en) 2010-05-27
EA017641B1 (en) 2013-02-28
GEP20135729B (en) 2013-01-25
KR20100051549A (en) 2010-05-17
RS51948B (en) 2012-02-29
WO2010052394A1 (en) 2010-05-14
MX2009012014A (en) 2010-05-27
GT200900288A (en) 2012-01-31
SI2184065T1 (en) 2011-10-28
JO2838B1 (en) 2014-09-15
ECSP099715A (en) 2010-06-29
IL201815A (en) 2013-08-29
JP2010111673A (en) 2010-05-20
DK2184065T3 (en) 2011-10-24
AU2009235984B2 (en) 2011-05-12
UY32202A (en) 2010-06-30
CR11094A (en) 2009-12-02
ZA200907753B (en) 2010-07-28
MA31418B1 (en) 2010-06-01
SG161186A1 (en) 2010-05-27
CY1112037T1 (en) 2015-11-04
US20100119459A1 (en) 2010-05-13
PL2184065T3 (en) 2011-12-30
JP2013049699A (en) 2013-03-14

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